4/20/2009 @ 6:00AM

Health Care's Cure: Electronic Records

Walk into any doctor’s office or hospital around the country and the first thing that you’ll be greeted with is a request for information, no matter how many times you’ve filled out these documents before.

The lack of computer automation in the U.S. health care system is both surprising and appalling, given the amount of money that’s being poured into medical research and the rising cost of premiums for health coverage. Insurance companies seem remarkably good at trimming services for patient care, mandating such things as pre-approval for many tests and operations, and limiting the amount of money being paid for various medical procedures. Yet they have done little to put pressure on one of the costliest inefficiencies in the medical system.

Thus, electronic records have multiple benefits. First of all, they ensure that patients have coverage, and explain exactly what is covered and what the deductible will be. This kind of information is often available on insurance sites, and many pharmacies already are connected to these systems electronically. For insurance companies, this can raise flags and avoid conflicts right up front.

Second, electronic records give a complete patient history, including what medications a patient is on–something that’s not always available to medical personnel–particularly if a patient is brought in on a gurney. Electronic records can alert health care staff to allergies, potential complications that can cost enormous sums of money to fix, and thereby avoid malpractice suits. These records can also lower doctors’ insurance, eliminate redundant tests, speed up treatment and cut costs across the board.

Third, even in the best-staffed hospitals, there are too few specialists and managing physicians. Electronic medical records allow plans for patient treatment to be set once by doctors and monitored by non-specialists. And these records can be matched against the best expert knowledge available to provide more consistent treatment, which can be updated as more data are entered into the system. This can further lower costs by eliminating many medical mistakes.

In the future, there will be on-body or in-body sensors that can monitor vital signs, blood (including glucose, cholesterol, white and red cells and a host of other tests), which can allow treatment in home or local offices. As futuristic as this stuff sounds, many of those sensors already are available. What’s missing is the electronic infrastructure to connect that information to the specialists who can interpret it.

Done correctly, this will provide better treatment with more follow-up at a lower cost with less inconvenience. It also can begin triggering alerts in case of a disease such as the 1918 Spanish Influenza, which was spread largely through human contact. Such contact can be limited by quarantining people with better home health care and less contact with healthy people. It’s hard to view pandemics in dollars and cents because there is the horrific human cost that overrides everything. But by way of comparison, the outbreak of SARS in 2003 eliminated an entire quarter of productivity in parts of Asia.

Setting up a modern electronic infrastructure for medical data, replete with the proper level of security and encryption, is a first step in adding efficiency across an entire system. After that, medical science and treatment can take some giant leaps toward coordinating knowledge and best practices the way the Internet has allowed other professions to grow. How bad can that be?